Cheng Dazhi, Yan Xiuxian, Gao Zhijie, Xu Keming, Zhou Xinlin, Chen Qian
Department of Pediatric Neurology, Capital Institute of Pediatrics, Beijing, China.
National Key Laboratory of Cognitive Neuroscience and Learning, Institute of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.
Pediatr Neurol. 2017 Jul;72:36-41.e1. doi: 10.1016/j.pediatrneurol.2016.12.005. Epub 2017 Jan 4.
Childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes are the most common forms of benign epilepsy syndromes. Although cognitive dysfunctions occur in children with both childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes, the similarity between their patterns of underlying cognitive impairments is not well understood. To describe these patterns, we examined multiple cognitive functions in children with childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes.
In this study, 43 children with childhood absence epilepsy, 47 children with benign childhood epilepsy with centrotemporal spikes, and 64 control subjects were recruited; all received a standardized assessment (i.e., computerized test battery) assessing processing speed, spatial skills, calculation, language ability, intelligence, visual attention, and executive function. Groups were compared in these cognitive domains. Simple regression analysis was used to analyze the effects of epilepsy-related clinical variables on cognitive test scores.
Compared with control subjects, children with childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes showed cognitive deficits in intelligence and executive function, but performed normally in language processing. Impairment in visual attention was specific to patients with childhood absence epilepsy, whereas impaired spatial ability was specific to the children with benign childhood epilepsy with centrotemporal spikes. Simple regression analysis showed syndrome-related clinical variables did not affect cognitive functions.
This study provides evidence of both common and distinctive cognitive features underlying the relative cognitive difficulties in children with childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes. Our data suggest that clinicians should pay particular attention to the specific cognitive deficits in children with childhood absence epilepsy and benign childhood epilepsy with centrotemporal spikes, to allow for more discriminative and potentially more effective interventions.
儿童失神癫痫和伴中央颞区棘波的儿童良性癫痫是良性癫痫综合征最常见的形式。虽然儿童失神癫痫和伴中央颞区棘波的儿童良性癫痫患儿均会出现认知功能障碍，但对二者潜在认知损害模式之间的相似性了解甚少。为描述这些模式，我们对儿童失神癫痫和伴中央颞区棘波的儿童良性癫痫患儿的多种认知功能进行了检查。
本研究招募了43例儿童失神癫痫患儿、47例伴中央颞区棘波的儿童良性癫痫患儿和64名对照受试者；所有人均接受了一项标准化评估（即电脑化测试组合），以评估处理速度、空间技能、计算能力、语言能力、智力、视觉注意力和执行功能。对这些认知领域的组间差异进行了比较。采用简单回归分析来分析癫痫相关临床变量对认知测试分数的影响。
与对照受试者相比，儿童失神癫痫和伴中央颞区棘波的儿童良性癫痫患儿在智力和执行功能方面存在认知缺陷，但在语言处理方面表现正常。视觉注意力受损是儿童失神癫痫患者所特有的，而空间能力受损是伴中央颞区棘波的儿童良性癫痫患儿所特有的。简单回归分析表明，综合征相关临床变量不影响认知功能。
本研究为儿童失神癫痫和伴中央颞区棘波的儿童良性癫痫患儿相对认知困难背后的共同和独特认知特征提供了证据。我们的数据表明，临床医生应特别关注儿童失神癫痫和伴中央颞区棘波的儿童良性癫痫患儿的特定认知缺陷，以便采取更具针对性且可能更有效的干预措施。
